In CMS
Feb 12th, 2019
If you thought the Department of Health and Human Services’ loosening of several Obamacare rules indicated less HIPAA enforcement, think again. The agency’s Office of Civil Rights settled $28.7 million worth of HIPAA violations in 2018, up 22 percent over the previous record year. The OCR also announced it achieved the single largest HIPAA settlement ...
In CMS
Feb 8th, 2019
Under the “primary care exception,” a medical resident may perform (and bill for) limited, specific evaluation and management services without the presence of a teaching physician. Here’s what you need to know when reporting these resident services. When the Primary Care Exception Applies Ordinarily, services furnished by medical residents are excluded from Medicare payment because ...
In Billing
Jan 30th, 2019
There are 13 new CLIA-waived tests effective April 1, 2019. The Center for Medicare & Medicaid Services (CMS) announced in CR11080 that these apply to facilities with a CLIA certificate of waiver. QW is Key to CLIA Waived Test Codes The modifier QW CLIA waived test must be appended to all but a handful of CPT ...
In Billing
Jan 25th, 2019
School faculty often does whatever it takes to help out a student to ensure they thrive in their educational environment. And then, there is Casey Smitherman, the superintendent of Elwood Community Schools in Indiana, who took nurturing to an extreme when she committed fraud to treat a student with strep throat. Smitherman was booked on ...
In Coding
Jan 23rd, 2019
Prior to receiving medical care, some potential patients may ask for a meet and greet visit with a physician. We expect this kind of “shopping around” when it comes to other types of purchases, and it’s become more common in healthcare. For example, many expectant parents now interview obstetricians before deciding who they’d like to ...